Kaiser Web-based Tool Enhances Patient Care, Part II

Yvonne Zhou, Ph.D.: The Panel Support Tool has enabled us to systemize the knowledge of our medical science and provide that information in an integrated way. So it is not just the one condition; it can provide many conditions. It’s not just one care gap, it is many care gaps—mammography screening, gap diabetes A1 screening. It can be many [care gaps] and it is all integrated together. That is really the key distinction between the Panel Support Tool and some other registries or other things. In addition it has data that is very real time, very accurate, and complete. So we have all of this information, and the support of data to our healthcare teams, at the point of care, really allow physicians to provide the best, latest recommended care accurately, 100 percent of the time.

Information technology [alone] is not going to improve healthcare, but if we marry IT with medical signs, and that is built into our clinical system, that is going to enhance our memory, and sometimes to expand our knowledge a little bit, to allow us to more reliably and more effectively accomplish our care goals.

HCI: One of the papers mentions that this is a dynamically updated system that each day reviews what is new and plugs that information into the records. Can you elaborate?

Unitan: That’s correct; and we used to print out similar information. But again, to Yvonne’s point, it would only generally deal with a couple of care gaps, and not 45 or 50. And as soon as that paper report hit the desk of the clinician, it was already out of date and just got more and more out of date. So you could send out [paper reports] quarterly, but they wound up being recycled in weeks often. Part of the freshness of the data is another thing that has gained greater acceptance and appreciation.

HCI: With so much more patient data available to clinicians and a lot more information coming through, this must add to a physician’s workload, right?

Unitan: It’s true, and in one article that we wrote there was a quote from a physician in Hawaii, who said, ‘This does not make my day any easier.’ You are now addressing a much wider range of conditions than you would have been addressing if you were just going after the chief complaint. But the physicians do feel that it makes their day better. They feel that they are not leaving a lot of stuff undone.

Our internal medicine physicians and family physicians are very compulsive people. They want to do the right thing every time they can. So by making it as easy as possible, to do what is extra work, we really are enhancing care. These patients come into our offices, some of them several times a year, the ones who have chronic conditions. But the physicians found out is that, the first time they used a Panel Support Tool on a patient, it was more, it added minutes to a visit, it added minutes to the visit. There were more orders, more things to look at. But the next time the patient came in, because all of that stuff had been dealt with, it made it easier, the time the patient came in the subsequent year. So it’s a double-edged sword. You are going to have to do this work at some point, if you are taking good care of your patients. And we just put it right up front and center.

Zhou: And sometimes an office visit may prevent another office visit; and also, to a certain degree, that helps patients, because it saves the patient time. It is really the next-generation population care; from population care perspective, it is really trying to address all of the care needs for the patients based on their condition. It is not just the illness, the chief complaints, and that’s all you have to do. We are trying to be proactive.

HCI: The Panel Support Tool is tightly integrated with HealthConnect. How important is the tight integration? Is this type of tool doable with any EMR out there?